Where perfection is the only acceptable goal.

4OurElders Pledge

The Pledge of Our Commitment to Transparency and Accountability at [Name of Home or Chain]

As the _____________ [title] of ___________________ [Home or Company], on my behalf and on behalf of all our employees I pledge and commit to conduct all our activities as a Resident-Centered, Resident-First Home, with care and service to our staff, our residents and their families, our vendors, our volunteers and our community we are a part of as our uncompromising and foremost goal. We commit to use this singular goal everyday in every facet our business, including hiring, retaining, compensating, training and even terminating our employees when it is necessary to do so to preserve our pledge of commitment to be a transparent and accountable Home. We pledge to formally and consistently encourage our employees at all levels to speak up whenever and wherever they have a safety or care or service concern; we pledge to listen to all such concerns and to timely, fully, fairly and without reprisal of any kind investigate and resolve all such concerns in the best interest of our staff and residents. Finally, we pledge to survey our staff, residents/patients and their families at least annually and to follow-up any dissatisfaction identified at any level with any group with timely corrective action as reasonably needed.

To ensure compliance with our pledge, we commit to keeping communications among our staff open and free of bottlenecks; we commit to having a formal, written communication cycle (example attached); we commit to having policies and procedures that actually are written, published and available so as to be used each day to guide our employees in caring for each other and their residents and families; we pledge to develop, collaboratively with our staff,a Mission, Values and Principles statement (example starting point model attached); and we pledge to make decisions and to take actions in every situation every day, even the tough ones, consistent with and in furtherance of our written communication cycle (see attached), our policies and procedures and our mission, values and principles statement.

We further commit to keeping data and making that data available to prospective residents and their families and to state and federal regulators, which can be easily used to determine if we are keeping our commitment transparency and accountability made in this pledge.Such data will include, but not be limited to: 1) how our staff, residents and families feel about their Home—would they recommend it to others, would staff put themselves or a loved one in our Home, do they feel our Home is committed to safety and to a Resident-Centered approach that has care and service as its chief focus, 2) Staff , resident and family survey results and trends, 3) Governmental Survey results and plans of correction;4) outcomes—Medicare resident results including average length of stay with discharge details; Non-Medicare resident results, including length of residency with discharge/bed hold details, hospitaladmissions and deaths, non-compliance with care plans and any other requirements under our policies and procedures, including documentation and medication errors, therapy results,falls history along with other events, claims and lawsuit information;5) any documentation required by and produced to any regulatory body, whether state or federal;and all rankings, evaluations, scores and competitor comparisons thatwe are aware of and have ready access to; 6) staff turnover by quarter and year-to-date by staff position and shift.

Finally, we pledge to collect and make available to potential residents and their families, the documents listed on the attachment to this form.

THIS PLEDGE of OUR COMMITMENT is MADE AND THIS DOCUMENT is SIGNED THIS ____ day 0f _____, 201_

DOCUMENTS TO OBTAIN OR GAIN ACCESS TO VIEW

Policies and Procedures

Room Rate Sheet

Occupancy Reports

Surveys – Complaint and annual including POC Plan of Correction) and status

Turnover statistics – if not kept, obtain staff data to do ourselves

Resident/Family Satisfaction Surveys if any and if none, ask “why not?”

Resident/Family Council minutes

Examples of actual complaints, investigations, and resolutions

Copy of all documents a resident is required to sign

Copy of actual anonymous progress notes and any other routine forms used to track aresident’s condition